Volumetric body composition parameters in predicting survival outcomes
of metastatic renal cell carcinoma patients treated with targeted
therapy
Abstract
Background: To explore the clinical significance of baseline volumetric
body composition parameters evaluated with computerized tomography (CT)
and their changes after 3-4 months from treatment initiation of targeted
therapy in patients with metastatic renal cell carcinoma (mRCC). Method:
This study included 108 Caucasian mRCC patients (Male/Female: 77/31)
treated with targeted therapy. Volumetric body composition parameters
including total adipose tissue index (TATI), subcutaneous adipose tissue
index (SATI), visceral adipose tissue index (VATI) and skeletal muscle
index (SMI) values were depicted from CT images at third lumbar vertebra
level through volumetric measurement software. Kaplan-Meier method and
the long test were used for estimation of progression free survival
(PFS) and overall survival (OS). Univariate and multivariate analyses
were done to determine the associations between clinic-pathologic
variables including VBC and survival outcomes. Results: The median PFS
and OS of all patients were 11 months and 46 months in patients
respectively. After adjustment for the variables including international
mRCC database consortium (IMDC) risk score, only a high skeletal muscle
index (SMI) was associated with better PFS (HR: 0.975, P=0.015). The
independent predictors for OS were VATI (HR 1.005, P=0.024), SATI (HR:
0.976, P=0.019) and TATI (HR: 0.982, P=0.035) in addition to IMDC risk
score. Conclusion: Our findings revealed that while SMI was the only
significant determinant parameter for PFS among VBC parameters, TATI,
VATI, and SATI were determined as independent predictors for OS in
addition to IMDC risk score.